2009-05-01_PERMIT FILE - M2009030

• Permit No: M2009030
• IBM Index Class Name: PERMIT FILE
• Doc Date: 5/1/2009
• Doc Name: New 110c application-revised applicant name
• From: Coal Bed Creek Construction, Inc.
• To: DRMS
• Email Name: RCO
• Media Type: D
• Archive: No

-2-
11. CorresEondence Information:
APPLICANT/OPERATOR (name, address,, and phone of name to be used on permit)
Contacts Name: aV (' of are5;6 6- Title: (A(. )W-,r
Company Name: C 00A eDE C reek ('nv?SEI'?cC?C?D h Sytc URA C 60"-ae'l
Street/P.O. Box: t 'w37 cR2 P.O. Box:
City:
State:
Zip Code: e1,'2j,?4
Telephone Number: (4 70 - 67-7 - 7 47
Fax Number. (276? - 677: 7 97
PERMITTING CONTACT (if different from applicant(operator above)
Contact's Name: ?', o-im t° Title:
Company Name:
Street/P.O. Box:
City:
State:
Telephone Number: ( ) -
Fax Number: ) -
P.O. Box:
Zip Code:
INSPECTION CONTACT
Contact's Name: Q WL Title:
Company Name:
Street/P.O. Box:
City:
State:
Telephone Number: ( ) -
Fax Number: ( ) -
P.O. Box:
Zip Code:
Agency: /l/lJYLt° _
Street:
City:
State: Zip Code;
Telephone Number: ( ) -
CC: STATE OR FEDERAL LANDOWNER (if any)
Agency:
Street.
City:
State:
Zip Code:
Telephone Number: 1-